The influence of four wound dressings on the kinetics of human walking

Dressing plantar wounds with foam dressings, is it too much pressure?

Diabetes and its associated complications have become a major concern locally, nationally and internationally. One such complication is lower extremity amputation, commonly preceded by chronic ulceration. The cause of this tissue breakdown is multi-faceted, but includes an increase in pressure, particularly plantar pressure. As such, the choice of dressing to be applied to a plantar wound should ideally not increase this pressure further. A commonly used and possibly more bulky dressing is the foam dressing. This pilot study investigates the plantar pressures associated with three common foam dressings (Allevyn(®), Lyofoam(®) and Mepilex(®)) compared with a control dressing (Melolin(®)). Twelve healthy males and 19 females [SD] age 36.6 [10.4] were measured using the F-scan plantar pressure measurement system. Substantial variations in individual pressure changes occurred across the foot. No significant differences were identified, once a Bonferroni correction was applied. In healthy adults, it could be concluded that foam dressings do not have any effect on the plantar pressures of the foot. However, the need remains for a robust trial on a pathological population.

Impact on Pain Control, Epidermal Stripping, Leakage of Wound Fluid, Ease of Use, Pressure Reduction, and Cost-Effectiveness

Selecting the "ideal dressing" for a wound is based on considerations of specific factors, including presence of necrotic tissue, bacterial load, volume of exudate, and the need for a bacterial barrier. Many dressings are now available, including hydrocellular foam dressings, that possess multiple characteristics of the ideal dressing. This article reviews the performance of hydrocellular foam dressings in terms of pain control, epidermal stripping, leakage of wound fluid, ease of use, pressure reduction, and cost-effectiveness.

A pilot study of the reaction forces at the heel during walking with the application of four different wound dressings

A laboratory investigation was conducted to ascertain the shock-absorbing properties of four wound dressings applied to the heel area of a convenience sample of volunteers. Four subjects walked across a force plate. Data were recorded for each subject barefoot, and then while the subject had a wound care dressing stuck to the plantar aspect of their heel. Eight trials were undertaken in the five different conditions resulting in 40 trials per subject. The results suggest that one dressing, Allevyn (Smith and Nephew Healthcare Ltd, Hull, UK), when compared to other dressing materials, exhibits similar reaction forces to the normal barefoot walking data for all subjects. However, results from the anterior posterior force show no major differences across the dressings when compared to barefoot walking. Wound care dressings that have an inherent shock-attenuating property may be advantageous when dealing with areas of the foot that come under excessive force.